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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES aL )lk�o(o-003 <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.ortg <br /> r <br /> SITE ADDRESS: / PROPERTY TAX# P Rryl1T# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long 1e961 description) <br /> OWNER ` C Phone/E-mail <br /> Address ,� ��/ City/State/Zip <br /> APPLICANT: Owner _Owner's Agent Contractor _Contractor's Agent _Tenant(must pr e a letter of consent from the owner to do work in the space) <br /> CONTRACTOR State Lic.# City Bus. Lic.# <br /> Address Pho /Email Z 0(0 ' Za —I( Z fJ <br /> CONTACT R PER IT - <br /> 110k <br /> atr#QJ— P ail c`1iI& hJ. Q 1r10��r�u• �a.v^ <br /> BUILDING PERMIT APPLICATION CONTR CT PRICE OF WORK $W_T(��, <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building A Gas_ Electric_ Other_ <br /> Building type. _Single Family _Duplex_To se Mulviv Commercial <br /> Type of project: New Addition _R odel Rep r_T.I. Sign_Sprinkler Demolition _Change of Use <br /> DESCRIPTION OF WORK(additional spa Vp,o vi d on to k): <br /> 6AIr H i S 11 rr S i h k � of k`Q Mt.� tivkvice fDh <br /> tri <br /> MECHANICAL MIT A PLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_ ti Addn _ _Repair Type of Project: _New_Addn _,Alteration—Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> I Gas rahge Dishwasher <br /> I Clot es dryer Clothes washer <br /> R ge hood Water heater <br /> haust fan ; Sink (service/bar/mop/etc.) <br /> eat pump i Backflow preventer(inside bldg) <br /> I Unit heater Urinal <br /> Boiler I Drinking Fountain <br /> ! Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> I Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby ce that I have read and exarrWed this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be complied <br /> with whet r s coed herei or not.The anting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I a u rized by the wner of this or perty to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> ner u• orize <br /> 9 nt <br /> Signature to (Revised 4/2015) <br />